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dc.contributor.authorRao, Vidar
dc.contributor.authorKlepstad, Pål
dc.contributor.authorLosvik, Ole Kristian
dc.contributor.authorSolheim, Ole
dc.date.accessioned2014-03-21T07:41:46Z
dc.date.available2014-03-21T07:41:46Z
dc.date.issued2013
dc.description.abstractBackground: Cerebral perfusion pressure (CPP) is defined as the difference between the mean arterial pressure (MAP) and the intracranial pressure (ICP). However, since patients with traumatic brain injury (TBI) are usually treated with head elevation, the recorded CPP values depends on the zero level used for calibration of the arterial blood pressure. Although international guidelines suggest that target values of optimal CPP are within the range of 50 – 70 mmHg in patients with TBI, the calibration of blood pressure, which directly influences CPP, is not described in the guidelines. The aim of this study was to review the literature used to support the CPP recommendations from the Brain Trauma Foundation, and to survey common clinical practice with respect to MAP, CPP targets and head elevation in European centres treating TBI patients. Methods: A review of the literature behind CPP threshold recommendations was performed. Authors were contacted if the publications did not report how MAP or CPP was measured. A short questionnaire related to measurement and treatment targets of MAP and CPP was sent to European neurosurgical centres treating patients with TBI. Results: Assessment methods for CPP measurement were only retrieved from 6 of the 11 studies cited in the TBI guidelines. Routines for assessment of CPP varied between these 6 publications. The 58 neurosurgical centres that answered our survey reported diverging routines on how to measure MAP and target CPP values. Higher CPP threshold were not observed if blood pressure was calibrated at the heart level (p = 0.51). Conclusions: The evidence behind the recommended CPP thresholds shows no consistency on how blood pressure is calibrated and clinical practice for MAP measurements and CPP target values seems to be highly variable. Until a consensus is reached on how to measure CPP, confusion will prevail.en
dc.identifier.citationScandinavian journal of trauma, resuscitation and emergency medicine 21(2013) nr. 78 s. -en
dc.identifier.cristinIDFRIDAID 1069508
dc.identifier.doihttp://dx.doi.org/10.1186/1757-7241-21-78
dc.identifier.issn1757-7241
dc.identifier.urihttps://hdl.handle.net/10037/6040
dc.identifier.urnURN:NBN:no-uit_munin_5755
dc.language.isoengen
dc.publisherBioMed Centralen
dc.rights.accessRightsopenAccess
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurology: 752en
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752en
dc.titleConfusion with cerebral perfusion pressure in a literature review of current guidelines and survey of clinical practise.en
dc.typeJournal articleen
dc.typeTidsskriftartikkelen
dc.typePeer revieweden


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